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- W4220781660 abstract "Abstract Background: Plasma cell-free DNA (cfDNA) metagenomic next-generation sequencing (mNGS) has emerged as an attractive and less invasive technique for pathogen detection. However, only few studies have demonstrated the need for simultaneous plasma and bronchoalveolar lavage fluid (BALF) mNGS in patients with severe pneumonia. Methods: This study retrospectively performed a paired comparison of BALF and plasma mNGS in critically ill patients with suspected severe pneumonia from April 2019 to December 2020, who were divided into mNGS results match and mismatch groups. The diagnostic performance was compared between BALF and plasma mNGS, using the clinical composite diagnosis as the reference standard. The impact of mNGS results was also assessed. Results: In total, 57 patients were included in this study and divided into the plasma mNGS match with BALF group (n=15) and mismatch group (n=40). There were no significant differences in baseline characteristics and total 28-day mortality between the match and mismatch groups. Fifty-three patients were diagnosed with microbiologically confirmed severe pneumonia, with 49% having polymicrobial infections. There were significant differences in the BALF sensitivity and plasma mNGS (100% vs. 42%, P < 0.001), and the diagnostic accuracy was 96% and 46%, respectively. There were no significant differences in the baseline characteristics and total 28-day mortality between the mNGS match and mismatch groups. However, in the mismatch group, more bacterial infections were detected in BALF mNGS than in plasma mNGS (47.5% vs. 23.1%, P = 0.040). Additionally, though plasma mNGS detected additional microorganisms in 11/53 patients, a beneficial impact was obtained only in 5 out of 11 patients. Conclusions: This study does not support the simultaneous mNGS of BALF and plasma samples. Prospective studies are required to clarify the optimal indications for cfDNA mNGS as an additional test for pneumonia." @default.
- W4220781660 created "2022-04-03" @default.
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- W4220781660 date "2022-03-07" @default.
- W4220781660 modified "2023-10-17" @default.
- W4220781660 title "A Paired Comparison of Plasma and Bronchoalveolar Lavage Fluid for Metagenomic Next-Generation Sequencing in Critically Ill Patients with Suspected Severe Pneumonia" @default.
- W4220781660 doi "https://doi.org/10.21203/rs.3.rs-1391662/v1" @default.
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